As ambulance services continue to move from a predominantly transport orientated service into a resource which offers provision of mobile healthcare, outcomes of patients seen by prehospital practitioners will face increased scrutiny. This research examines the correlation between decisions taken by emergency care practitioners (ECPs) as to whether or not to transfer patients with a respiratory condition to hospital, and the pandemic medical early warning score (PMEWS). The PMEWS total is calculated from a combination of physiological measures, age, chronic disease presence, functional ability, and social factors.
Patients whom ECPs diagnosed with a respiratory illness were retrospectively identified from the ambulance service's records and these individual's PMEWS variables and scores were calculated. In the event that one or two components were missing from the records then these were rated as ‘normal’, but if three or more variables were missing then these patients were excluded from the study.
In total, 300 patients were included. Most of these were 65 years or older (217/72%), had a co-morbid condition or functional impairment (272/91%), and yet only 98 (33%) required hospital assessment or admission. The results suggest good correlation between the PMEWS score and the decision to manage patients in the community or refer them for hospital assessment. However, the researchers recommend that further prospective research is needed to validate the use of early warning scoring systems in out-of-hospital urgent care settings.